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Hospital & Medical Practice Design, Development & Management
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Leith MacMillan answers some of the most common questions asked of Day Hospital Consulting

What do you think are the most critical factors in planning a Day Hospital?

Commercial feasibility is of paramount importance. It is essential to ‘do your homework’, and analyze the demographics, including: health insurance demographics, need for services, population and growth, competitors in the area, current utilization of proposed services in the area provided elsewhere, committed proceduralists and forming a design team that will work within the Day Hospital, including a medical practitioner, anaesthetist, clinical manager, and officer manager and any other key staff. It is also very important to have a pivotal person to liaise with State Government health bodies and health insurance funds.

What is the process of starting up a Day Hospital?

If a client wants to develop a Day Hospital, in the early stages, discussions must be conducted with:

  • State health bodies
  • Key stakeholders – those who are part of the venture
  • Health insurance funds
  • Architectural company – with demonstrated experience with health facilities
  • Accreditation bodies
  • Medical equipment suppliers

And very early in the planning:

  • Perform feasibility and demographical analysis

Why do doctors or a group of doctors contemplate opening a Day Hospital?

Doctors do their specialty and do it well. They believe they can provide their patient better service in their own Day Hospital. It offers autonomy and provides a valuable asset for when the want to exit from the profession or retire. It can be sold or alternatively provide a continuing income stream.

How did you get into this specialised area in the first place?

In the early 1980’s, as a Registered Nurse, I was instrumental in developing a Day Procedure Unit in a large private hospital in Brisbane. My role and responsibility grew and I was charge nurse of the unit many years. In the mid 1990’s, I was then recruited to work for a company that went on to develop 3 freestanding Day Hospitals for which I was responsible for the design, development and management. Whilst CEO of these Day Hospitals, I saw the need to strengthen Day Hospitals’ profile and representation. One of my achievements was resurrection of the Australian Day Hospital Association (ADHA).

Is your business purely contained to the Day Hospital Industry?

No, services can be provided to: Small to Medium Private Hospitals, Day Procedure Units, Day Surgery Units, Doctors Consulting Suites and Medical Practices – both General Practitioners and Specialists.

I Understand that you have been consulted on numerous occasions, where accreditation issues have been critical. What services have you provided under these circumstances?

Accreditation commitment commences right at the point when the Day Hospital is in the early planning stages. Day Hospitals elect to choose between the Australian Council on Healthcare Standards (ACHS) or ISO: 9001. The overarching strategy is to implement a quality management system focused on risk and safety within the facility.

In the past you have been involved with the design and development of Day Surgeries in major overnight Hospitals as well as stand alone Facilities. Can your Company assist in the spectrum to be able to provide services across this spectrum?

Yes, particularly in the case of part of the design and planning team. Day Hospital Consulting can provide some key advice in the early stages to overcome or prevent any future obstacles that may have occurred.

The regulations differ for Day Hospital Facilities when compared with Private Overnight Hospitals, but this is not an issue.

Managers of Day Hospitals are required to have a broad skill and knowledge base. How does Day Hospital Consulting Pty Ltd cover all these aspects of development?

The scope of knowledge that the key leader in the business must know is enormous. Having acquired extensive knowledge over the years with learning through networking groups, on the ground experience, benchmarking, educational opportunities, and being part of committees, boards in key peak associations and organizations, I actively update my knowledge base with networking and attendance at industry related activities. This enables broad, sound and current advice.

Is your scope of work contained to the initial stages of development?

No. The process commences with the initial discussions, and continuing on to feasibility. It is critical to continue to work as part of the planning team with the architect, builder and planning team (owner + key staff and stake holders).

Procurement of equipment and supplies is another key area that must be addressed and overseen, as well as medical plumbing - gases and suction etc.

Advice and guidance can continue right up until commissioning or even after the building has been completed and opened. Often client need assistance with the governance and operational functions until the first year or so of service.

What are the key success indicators over the years?

The main factor would be having had the exposure to the breadth of functions within the Day Hospital environment and being able to acquire the skill base in each of these functions. Having a forward plan is vitally important - anticipate what may happen next, and action issues immediately they arise. To be able to anticipate reactions allowing you to be ready for the outcome, and also encourage enthusiasm with your team, keep them focused and striving to meet the Organsational objectives.

Growing with the industry I have been privileged in my past work and also as chair of the ADHA to identify the need for advisors of this type in the industry and responded accordingly. I define the wants and needs of clients and deliver outcomes, with support and guidance, to meet their objectives. Getting a facility from vision to opening and beyond is where Day Hospital Consulting Pty Ltd shines.

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